When to give up on breastfeeding

I read a post the other day that upset me. It was the first of many things that upset me that day and I don't seem to be able to let go. In the past, I've turned comments that upset me into posts (like Birth Plan: Yes or No? and Lactivism and the Homelessness Problem), so I thought perhaps the best way to get past what bothered me so much about this post was to write about it.

A woman wrote an honest first person account of her difficulties with her attempt to breastfeed her baby. Her story is sad. She had significant difficulties breastfeeding. She got questionable advice. She had people judging her instead of helping her. In short, the cards were stacked against her and she was set up for failure. I don't blame her. This happens to a lot of women and it is unfortunate. I can't say for sure if she would have been able to breastfeed successfully if things had been different and even if she could have, hindsight is 20/20 and there is no point in rehashing that now. So while I was saddened by her story, I don't judge her (or anyone) for choosing formula if they feel that they cannot breastfeed for whatever reason.

That said, I think that any mom who does want to breastfeed should be encouraged to do so. I know that many moms have difficulty with breastfeeding at the start, but that they overcome those difficulties with time and with the right type of support. With that in mind, let me share with you what she said that upset me so much. She said that she had bottle fed formula and pumped for five weeks and that she feels after two weeks if breastfeeding isn't working for a mother, she needs to just bottle feed formula. This really upset me.

I ended up leaving a long comment there, but I'm not sure if my point got across and I also wanted to collect a bit of data to ensure I wasn't off base for thinking what I did. So I put up a poll on my blog and asked moms to tell me if they had a rough start breastfeeding and if it was resolved by the 2 week period. Here are the results (265 people voted):

Question: Did you have a rough start with breastfeeding?

• No, it was easy - 27%
  


• Yes, but by the 2 week mark everything was going smoothly - 21%


• Yes, and it took more than 2 weeks to get all of our problems worked out - 41%


• Yes, and I ended up exclusively pumping - 3%


• Yes, and I switched to formula at or before the 2 week mark - 3%


• Yes, and I switched to formula after the 2 week mark - 2%

Let's do some math. According to these results, 46% of women that did go on to have a successful breastfeeding relationship were still struggling at 2 weeks postpartum.  If they are like me and hundreds of other women whose stories I have read, they would probably say that breastfeeding really wasn't working for them at 2 weeks. So what would the consequence be if all of these women followed this woman's advice and switched to formula at 2 weeks?

In Canada, almost 86% of women that do initiate breastfeeding end up breastfeeding beyond 2 weeks.  In fact, almost 50% of them make it to 6 months and 9% end up going on for more than a year (source Statistics Canada 2003 data).  Based on the data in my poll, if everyone that was having trouble breastfeeding gave up at 2 weeks, 46% would continue breastfeeding past 2 weeks, 27% would be breastfeeding at 6 months, and 5% would be breastfeeding at a year. What would the consequences of this be? Essentially, the well documented health benefits of breastfeeding for moms and babies would be cut almost in half. We would see more babies and children getting sick. We would see more mothers dying of breast cancer (I did the math on this in Save Yourself, Save our Health Care System).


To use an analogy, a lot of mothers have trouble giving birth vaginally and in Canada 1 in 4 babies are delivered by c-section (it is even higher in the United States). A lot of moms go into their first birth experience expecting to deliver vaginally, they may labour for a really long time, struggle a lot, go through a lot of pain and then ultimately end up with a c-section. Maybe that c-section was necessary in the end. Maybe that c-section happened as a result of unnecessary interventions. Either way, the mom is sure to be upset that she didn't have the birth experience that she wanted and may feel that she should have given up on trying to deliver vaginally earlier because that would have saved her from a lot of unnecessary pain, effort, and emotional trauma. Maybe she decides that about 4 hours of active labour is how much effort she should have given before giving up. If that is her choice, that is fine. But if she starts convincing other mothers that they should give up on having a vaginal birth after 4 hours of active labour, we would see the c-section rate soar astronomically, with significant costs to our health care system and increased risks to moms and babies.

That would be unfortunate and ridiculous.

A lot of moms struggle with breastfeeding. In addition to my story, you can read the stories of Lindsay, Maria, Dani, Katrina, Beth, Tara, Christina and many others that replied to my poll. You can go to message boards like the kellymom message boards and scour the newborn forum to see how many moms times how many different problems are possible. It is normal for it to be difficult, but with the right type of support most moms can overcome those difficulties.

Máire Clements, a lactation consultant and reader of my blog, left a comment outlining her concerns with the alarming percentage of mothers that struggle with breastfeeding. Here is part of what she had to say:

The tug of war seems to be between those who insist on the baby doing it naturally no matter what that looks or feels like, and the experts micro-managing the process by emphasizing the use of gadgets and measurements to assess whether breastfeeding is successful.

What is often lost in the flurry of maternal hormones and well meaning encouragement from family and friends is the awareness that a positive breastfeeding experience will not always happen on automatic pilot.

It is a skill that needs to be learned, preferably not through painful trial and error...

We must shift our attention back to helping mothers achieve a quality connection which is pain-free and transfers ample milk to their babies. It is through consistency in the latch-on that feedings can become optimized and many problems can be avoided or resolved.

The mother is the thinking partner and her baby feeding well drives the breastfeeding system and milk supply.

From my own experience and from reading the stories of many mothers, the problem is that a lot of well meaning health care professionals or friends with insufficient training in lactation will tell mothers things or suggest things that are detrimental to the breastfeeding relationship. If that was not bad enough, actual lactation experts and advocates often use language that is hurtful to moms that are trying really hard and that can turn them off of breastfeeding. They will say things like "every mom can breastfeed" or "if it hurts, it must be your latch". Even if those things are mostly true, lactation professionals need to choose their words carefully so that they don't place blame on the mother or make her feel inadequate. Like Máire said above, the mother is a thinking partner.

If a mom is struggling with breastfeeding, please don't tell her to quit at two weeks if it isn't working out for her. Instead, tell her that you know how hard it is. Tell her that you are proud of her for trying so hard. Tell her that it is her choice whether to continue or not and that you fully support her no matter what her decision is and that she is a great mother no matter what decision she makes. Read up about what it really means to support a breastfeeding mother. Give her a hug. Let her cry. Then let her heart guide her about when or if to give up.

I sympathize with the woman that wrote the original post and I know her heart is in the right place when she tells people they should give up at 2 weeks, but I don't think she realizes that she is undermining them if they do want to continue and that recommendations like this can have disastrous results for breastfeeding rates and subsequently for our healthcare system.

Thank you to everyone that took the time to vote in the poll and to these kind people who took the time to share their stories in the comments: bessie.viola, strwberryjoy, Jennifer, Amanda, Carla (MamaHeartsBaby), Anna, Fi, Shannon, Cynthia, Rhyah, Emily Jones, lifeafterjasper, TopHat, Tyla, Kelly, April ~ EnchantedDandelions, Tiffany, Brenda, Jennifer, Amber, Anisa, Tracy, Noble Savage, Ailie, joyce, Karen Angstadt, Tara @ Feels like home, Jessica, Judy - Mommy News Blog, Carrie, Brandy Tanner, diana, IrinaK, Carrie (a different Carrie), Paige, Lindsey, Bonnie, Sarah V., Alicja, Maria, Kimberly, Maria, Renee, Michele, Máire Clements, Samantha, Lindsay, Ashley and Melodie.

Comments

[Judy - Mommy News Blog]

This is a great post! I can see why colleen's comments made you so upset and I am so impressed about the way you collected data and wrote a great post about it!! I have detailed my nursing relationship with my son (although didn't go into a lot about our early difficulties - that will be another post). You can read it here: http://mommynewsblog.com/gentle-weaning-one-moms-journey-through-breastfeeding/

Thank you for your thoughtful post and for being such a great advocate for breastfeeding moms!!

[Christina | MamasWorldwide]

I'm glad you wrote this, and thanks for linking to my breastfeeding story. As you know, I had a really tough time. I had a breast reduction when I was a teenager, so I am one of those 5% of moms that had true low supply problems. I wanted to breastfeed more than anything, and I'm so glad everyone around me was completely supportive. I think if any of my friends or family members had told me to quit after two weeks, it would have been extremely demoralizing. I'm not sure I'd still be breastfeeding, 19 months later, if I'd been told that by someone.

[Lucie @ Unconventional Origins]

This post hit home, made me tear up a little! I don't know if it was the part about trouble with breastfeeding, or ending up with a csec after a long painful labor (39 hours, 20 no meds), but it hit home.

Breast feeding was hard and painful and my son was small when he was born. My partner was really supportive (even when I became discouraged) and I didn't give up. Eventually things smoothed out and I breastfeed exclusively for a year. The things that made it hardest for me was that pumping NEVER worked, no matter what kind I would try, the most I would ever get was like 3.5 ounces total from each, and that was an unusually good day. And that took 20 or so minutes. It was so frustrating. I don't know if that happens to other women, but it made it hard because bottle feeding stored milk was impossible. I was ALWAYS on call. I tried different pumps too, but nothing made pumping work for me.

But was it worth it? YES. I would tell anyone to keep trying, definitely for more than 2 weeks. I would say there's nothing wrong with you if it's still tricky up into the first six.

[FamilyNature]

Great post. I am a woman who was still having trouble at 2 weeks. It was *eight* weeks before my son was consistently gaining and I could breastfeed pain-free.

I had lots of help: dh was not working at the time and was committed to helping me 24/7 and was 100% supportive; mil is a IBCLC and would drop everything and come to our home if we called her; my midwife was passionate about breastfeeding, visited me ever other day, sometimes every day; I saw Dr. Jack Newman regularly until my son was 8 weeks old. Still, I struggled.

I had cracked bleeding nipples, low milk supply, Reynaud's phenomenon, mastitis and persistent thrush. I cried and cried and cried.

Seven years later I have four children, all of whom were exclusively breastfed (with the exception of my first who was supplemented with formula for a short time while I was having difficulty), all of whom either were or will be breastfed for at least two years. I have breastfed through three pregnancies and I have tandem nursed.

While the first eight weeks after my first was born was extrememly difficult, and looking back I honestly don't know how I coped, I am so grateful that I never switched to formula.

Looking back that eight weeks was such a teeny, tiny portion of my life I barely remember it. What I remember most are the wonderful things about breastfeeding: the love, the comfort, the sleepy smiles, the pure joy; all of that times four. What I would have missed if I'd quit at two weeks.

[Rashel]

Thank you for this! I have been trying to write about my own experience struggling with medical folks who were unsupportive of breastfeeding (you have no milk and this baby will never breastfeed) and didn't understand even basic breastfeeding workings (supply and demand) and a child welfare system that puts all of it's trust in the medical system. If I had not already been breastfeeding for seven years, if I was not a dedicated breastfeeder and if I had not been so educated myself I would have given up. Everything they did to "help" was a hindrance and any new mother without a strong dedication would have given up. It is very sad that there are pediatricians out there who know so little and have no encouragement for breastfeeding.

[Sylva]

Thanks for this great post! I had three cases of mastitis in the first eight weeks. Baby latched well, was painless, gained great... but I 1. had oversupply, and 2. needed more rest. So once that got sorted out, we were fine... but 2 weeks out? I was terribly weak from the first case of mastitis!! I had had a 104.9 F fever a few days prior, and just felt awful.

A few weeks later with the 2nd case, my devoted husband asked me when it was time to switch to formula. My response? NEVER. But we did have to address his fears - that if I continued to get mastitis, I would become resistant to the antibiotics, and could get a superbug and die, leaving him without his soulmate and with an infant to raise alone. However irrational these fears may be, to a new dad, they are very real fears. Thank goodness I started out a breastfeeding advocate, and had the support and the deep wells of knowledge to call upon from discussion forums and kellymom.com.

We are still nursing at 11 months old (after several nursing strikes!) and I hope to make it beyond 18+ months.

[babyREADY]

Thank you once again for a wonderful post!!!

As someone who makes visits to the homes of new moms and their breastfeeding babies I want to add two points:

One: get help AS SOON AS you need it - and that means doing your research BEFORE baby is born so you will know where to turn to ask for in-home help. (BTW, in-home help is **very** different that clinic help because it can be difficult to translate skills learned in a clinic setting to the home.) I often get breastfeeding consultation calls from moms who have 10 day-old babies. As I arrive at the house the look I get from mom, at the door, silently warns me: "if you can make this breastfeeding thing work properly and without any pain or discomfort now and always TODAY with this ONE visit then I will keep going; otherwise I am throwing in the towel." By the time it has come to that it is often too late to fix the problem overnight. Make small corrections? Sure. But not a complete fix. Not that fast. If you have waited to get help (to see if the problem corrects itself - and sometimes it does) or had trouble finding [good] help then please understand that it might take more than one visit to make everything flow smoothly.

Two: find one or two people whose opinions about breastfeeding you **truly** trust. One of the most common comments I hear from the moms I meet is that they have had not only such bad advice but so many differing opinions that they don't know who is right. Find someone you feel you can trust and be honest with them if the advice they are offering is not helping. If they are worth their salt then they will help modify the help they are giving to help find the perfect solution.

It takes more than two weeks to truly appreciate the permanence of parenthood, that this new baby is staying FOREVER. If it takes more than two weeks to get used to the idea of *having* a baby then why wouldn't we assume it might take more than two weeks to get used to learning how to care for our babies; including mothering through breastfeeding?

Thanks again for your great post. You always leave me wanting more!!!

[phdinparenting]

@ Lucie: 3.5 oz total from each is fabulous! Most moms are lucky to get 3.5 oz total from both. I think pumping volumes is another area where there is not enough good information and a few moms with oversupply end up creating unrealistic expectations for other moms.

[Jennifer]

I'm back! :)
I, like Lucie, am fighting back tears a bit. As a doula, I have to maintain that delicate balance between offering evidence and data and offering opinions, even when I feel very strongly about something. This post has solidified my belief that I need to go ahead and get certified as a lactation educator. I offer help and support to all my moms, but I see more and more the need for trained AND experienced help in this arena. Even as a staunch believer in breastfeeding, I struggled terribly with ALL THREE of my children! I had over-abundant milk and a VERY forceful letdown reflex. I know there are worse problems, but I imagine if I had been someone more uncomfortable with being open about breastfeeding, I would never have been able to handle it in public when my milk would spray everywhere (go ahead and chuckle. I do!)
Thank you for being such a great researcher, for putting so much care and time into your posts. And thank you also for championing so compassionately the cause of healthy families.
(((hugs)))

[Jennifer]

Oooh - I also wanted to add these thoughts: my first born was 10 weeks early and I had to pump. It was absolutely vital for her health to get those antibodies. I did it for the first three months of her life, combined with nursing when she was a month old, and felt like a martyr or something. But get this - my sister in law did it for 14 months!! I feel even more strongly about this issue than she does, in face - way more strongly. But she did it. My hat is off to women like that. It's hard to parent. It is *really* hard, sometimes. But having little ones is a season in our lives, like any other, and it doesn't last forever. If we can remember that, it might make the difficult times just a bit easier.

[pantrygirl]

thank you for a wonderful post. I agree,2 weeks is just too soon. unfortunately aside from the comments and reason stated before regarding the lack of support women receive on the subject of breastfeeding, is the fact that many folks are so concerned with a mother's emotional state post partum they think by offering an 'easy' alternative, they are assisting moms.
For me, it was the contrary. I felt professional and amateur advice of 'it's ok to give formula' was a cop out. I didn't want to hear that. I wanted to hear, cheerleading and encouragement. I wanted to hear, advice and positive feedback. What I got was, 'well, you can always formula feed or bottle feed.' How the heck is that supposed to make me feel better?
Yes, the first two weeks are super tough, especially if you have breastfeeding issues or lack of support but there are turning point (for me 5 weeks was a major turning point). Moms need encouragement and positive feedback from friends, family and professionals not justifications or 'solutions'.

[phdinparenting]

@ Jennifer - Thank you for your thoughts. I also pumped. I pumped with my son because he didn't latch on until he was 7.5 weeks old and even then it took us another 7.5 weeks until his latch was good enough to stop pumping. And then I went back to work. So I was nursing when we were together, but pumping at work for another 9 months (until he was a year), at which point I continued nursing on demand when we were together, but hung up the horns. With my daughter, I nursed her exclusively for the first 6 months, but pumped once per day most days to build a freezer stash for when I went back to work. I continued pumping at work until she was 18 months old. She is turning 2 this month and still nurses on demand when we are together. I didn't feel like a martyr for pumping. I felt like I was giving my children a gift that only I could give them. I felt like when we were separated, at least I could provide something from me to them.

[Mebs]

I had to learn, as did my baby, how to nurse. We learned and have been at it for nine months and going.

PS - Grammar note from your post. "That said, I think that any mom that ("THAT" SHOULD BE A "WHO") does want to breastfeed should be encouraged to do so.

People are a "who" and not a "that." Thanks for a good post.

[Amber]

Wow, interesting post. I'm surprised at the 2 week suggestion from the original post you're commenting on. People kept telling me it would get better at 6 weeks, and I did find that true. My daughter had a bad latch, it hurt every time I fed her, less as time went on but still. She self weaned at 14.5 months. I could never get the right support, I had no transport to get to LLL meetings, and the hospital and Ped were useless in that regard so I battled on. I had to go back to work at 5.5 weeks and pumped until she was 6.5mos old and could go without a bottle. I pumped sitting on a bathroom floor... I think I might be more traumatised by that than I realise.

[Fi]

Agree wholeheartedly with what you say here - women should be supported in their decision to bf even if it's difficult (and, yes, it IS difficult but totally worth it.)

Sometimes I feel quite judged by my decision to stick with bf even when it is a struggle.. And I KNOW formula feeding mothers feel judged too. So it seems that we are all being made to feel inadequate, at some times, because of our feeding choices. Sigh.

[Maria]

What I wonder-- why is two or five weeks too long to pump? There are a lot of women who exclusively pump for six months, a year, or more. Two of my friends have pumped for far longer than two weeks (one due to nursing/latch struggles, one due to premies). I also am offended at the thought that all women should give up at two weeks. It is irresponsible of her to say that and then try to have others back her up as it being her opinion. She is putting it out there that that is "the" time frame.

I unsubscribed to that site after some other posts I thought were questionable, and now I am more glad than ever that I did.

[Kelly]

Great post. A a mom who gave up within that two week window this whole discussion stings. It stings a lot. But, you know what -- so do the first six to eight weeks of motherhood. In fact they more than sting. They suck. It was the worst soul-sucking experience of my life. I loved my baby, but I hated my life for those two months. It isn't the most positive, "sunshine and lollipops" thing to say to a new mom, but it would be accurate: "Keep up with the breastfeeding, I know it is hard and awful, but even if you throw in the towel now, its not like the quality of your life is going to improve immediately. This mothering gig doesn't really get good until your baby can smile at you."

And we so often throw out that term "support." I think we need to flesh it out. Sometimes support is cleaning a new mom's bathroom (e.g., see Anne Lamott's Operating Instructions), cooking her a good meal, taking care of older children, or generally standing guard over a new mom's right to do nothing but sleep and feed her new baby for 30 days.

Sometimes "support" is encouraging a sleep-deprived, struggling new mom to just eek out one more day trying to breastfeed her baby. And then the next day. And the one after.

And sometimes, albeit rarely, support is telling a new mom who has struggled for weeks (or months) , whose baby is suffering, that it is okay to find a different way to feed her baby. But be prepared: that sort of support cannot end when that first bottle of formula is given. Mom is going to need support for the sadness and grief she may feel over the loss of a breastfeeding relationship. Its been four+ years for me and I still grieve for that loss.

I am due in six weeks and I worked this entire pregnancy to set up a support system to do all of the above. Well, this time, I hope not that last part.

Thank you for this discussion.

[Sally Wendkos Olds]

This is such an important post. So many women who have breastfeeding problems at 2 weeks, or even at 4 weeks, can, with help, overcome them and go on to have a long breastfeeding relationship that benefits them and their babies. This is why, in THE COMPLETE BOOK OF BREASTFEEDING, Dr. Laura Marks and I encourage new moms to get help at the first sign of trouble -- not to wait until things get worse. Thanks for your good discussion.

[phdinparenting]

@Kelly Thank you for your comment. I hope that you will have a more enjoyable start with your next baby than you did with your first. I agree with you about support taking on many different forms and in fact you reminded me that I forgot to link to another post of mine on that topic in this post. I'm going to go back and edit and do that now, but I'll add it here too: http://www.phdinparenting.com/2008/11/01/what-does-support-look-like/" rel="nofollow">What does support look like: What to do and not to do to support a breastfeeding mother.

[Tiffany]

Thanks for this poll and information. I also read that post last week and the 2 week comment had me upset as well. I understand that some moms had a rough go of it but giving bad advice is not helpful to anyone. Most breastfeeding problems can be overcome with time and it does usually take longer than 2 weeks.

[DaniGirl]

This is a terrific post, and I'm honoured that you pointed out one of my posts on breastfeeding. I wish I'd had someone strong in my corner advocating and cheering me on when I was struggling with breastfeeding my first child. We made it, but it was only my own sheer stubbornness that saw us through. Because I'd love to help someone in any small way possible, here's another post I wrote a year or so ago about how hard breastfeeding was for me, but why I stuck with it: http://danigirl.ca/blog/2007/10/10/the-breast-fest/

And, for what it's worth, after writing the post that you linked to, where I was in unbearable pain and frustrated with nursing at just one week postpartum, we went through a real struggle with my supply and the baby's weight gain. I had to start supplementing with formula, and kept nursing three to five times a day while supplementing with two 8 oz bottles per day. Lucas is now 13 months old (today, in fact!) and I'm still nursing him once a day. So it just goes to show you that even a terrible start can still end well with support, perserverence and an ounce or two of sheer stubbornness!

[Nicole]

This is a fabulous post.
My family was very supportive and pro-breastfeeding -- at first.
To them the concern wasn't that I was breastfeeding to start with but as he got older it got very difficult for me to keep up with his demand and that's where the discouragement started (probably 3 or 4 months in).
I did finally stop towards the end of 9 months but I wish I hadn't.

When he was born the nurses in the hospital did not encourage breastfeeding at all and they told me it was because I was young and single and wouldn't be able to keep it up.

I hadn't had a single problem getting started and I had an ample milk supply but people telling me just to give up on it because it MIGHT not work out was very disheartening and discouraging.

I will be sure to pass this post on!

[Francesca]

This is an excellent post. Informative and supportive.
Well done! GREAT GREAT post.
I'd just like to add that i really agree on the fcat that there needs to be more support out there for breastfeeding mothers. From being to breastfeed out in public without being judged to lactation consultants as easy and affordable to get hold of as say a bank manager when you aren't paying your bank loan!
My little one suffered with reflux and after 2 weeks when the reflux kicked in his breastfeeding was on and off on and off and really rather difficult. I knew no better and assumed that this is just how it was. He would scream and arch and be on one second and off the next and not at all relaxed or settled. fallingasleep at my boob?! no way! My mum told me it was because my milk was flowing too quickly and it was bad and all sorts. I just plugged on. Kept at it. At 7ish months he was breastfeeding normally (i.e. enjoying it and snuggling in and falling asleep) and all of a sudden everyone is telling me to get him OFF the boob. That breastfeeding a 7 month old was damaging to his psychological health. And if not damaging it was freaky and a bit of a circus show.
I was appalled.
Had i just done 6-7 months of nightmare breastfeeding to get to th egood bit and have to give it all up?? that made no sense
So again, me being me, i didn't listen to what everyone else had to say and what all the books say and the GP was saying and i just kept going
Maxi is now weaning himself and we are slopwly getting there. He is 18 months old
I wish there were more support for mothers who are not like me and who do listen to what health visitors, mothers, mothers in law etc etc tell them. Sometimes the advice given by the previous generation (the one that was brought up to believe formula was best) isn't always good advice

[Anisa]

Thank you Thank you Thank you SO MUCH for posting this follow up to the one on G&CM. It is needed. I've been spreading the word about your blog... so glad I found you!

[Melodie]

HIGH FIVE! Excellent, articulate, well balanced and fair post! I completely hear what Francesca says too. I come from a pretty old fashioned unsupportive family who just don't get breastfeeding. Especially my Grandma. I hate that I don't get the support I need from some of the people most important to me. I have a terrific group of breastfeeding friends who have helped shape the breastfeeding activist I am now. Without them I may have buckled under the pressure of the barrage of advice to wean way too early for either of my dds.

[Amber]

I agree that we should absolutely encourage moms to breastfeed, particularly when they want that for their babies. It's a struggle to know how best to support women, though. In my own case I received so much conflicting information from so many people. I also received the well-meaning but guilt-inducing comments.

Now I'm a LLL Leader, and I'm on the other side. It's something I struggle with, knowing that by the time they call me a mom may have already heard 15 different opinions and suggestions. How do you balance that? How do you provide support and information without being yet another voice with yet another idea? I don't think there are easy answers, since every case is different. My hope is that simply being aware of how confusing and difficult it is, and providing a sympathetic and supportive ear, can be a help when a mom is struggling.

[Shannon]

Excellent and informative post! I am so, so fortunate to have had tremendous luck with breastfeeding, but I also credit a lot of my success to the amazing support I received from my midwives in the first six weeks with each of my babies. I didn't have a lot of friends or family members who breastfed, or who had any helpful information to share, so my midwives were my lifeline to nursing in those early weeks.

I am so sad when I hear of the difficulties so many women experience, and the conflicting information they are often given.

[Marianne]

Excellent post! I am one of the small (5%) of women who truly have supply issues (in my case, a combination of PCOS, pre-eclampsia, premature birth, induced labour, c-section and continuing high blood pressure for a period after birth). But I knew I wanted to breastfeed and kept going, even when all the health professionals and even lactation consultants I spoke to seemed surprised I was still at it at six weeks! I pumped (boy did I pump!), I tried herbs, teas, oatmeal, lactogenic foods, domperidone, drank water like crazy, read every online resource on breastfeeding I could find, tried a supplemental feeder and consulted LC's and nurses for help. At 2 months I finally got my supply up to about 25% of what my daughter was eating in a day. My supply plateaued at that level, even as my daughter's appetite grew, but I continued on breastfeeding and pumping and making up the difference with a growing proportion of formula.
I am still heartbroken that I was not able to exclusively breastfeed. I still wonder what I could have tried or done differently to breastfeed longer than the 8 months we managed. But I know I did my best to give my daughter the best possible start in life, and that I didn't give up.
I feel almost irrationally angry when I hear of women wo say "I tried" or "I didn't have enough milk", but who gave up at less than the 2 week mark. A good breastfeeding relationship often takes work for mother and baby to learn how to do it. I really feel 6 weeks is probably a good length of time to give it a real try. Certainly in my books, anything less than 2 weeks (and consulting AT LEAST 2 people knowledgeable about breastfeeding for help) can't possibly be counted as "trying".

[Kelly]

Marianne -- I understand your anger; however, I am pretty sure I could not have managed what you went through. Everyone has their own breaking point. And so long as a mom receives the right information and support, I would not feel "anger" towards any mom who decides to give up rather than continue pursuing heroic measures in order to provide a 25% supply of her child's nutritional needs. I TRULY do not mean to diminish what you went through. Indeed, just the opposite. You went above and beyond. Myself, I cannot feel anger towards a mom who makes a different choice; sympathy for the loss of her breastfeeding relationship, yes, but "anger", no.

[Please vote in poll on breastf]

[...] note: The poll is now closed. You can view the results in my follow-up post and read the comments below. var addthis_pub = 'phdinparenting'; var addthis_language = 'en';var [...]

[Erin]

What a wonderful post. I have a pregnant friend and am trying to figure out how to best balance the lactivist in me with the supportive friend, especially if she struggles. Your post helped me clarify how I need to support her.

For me, breastfeeding was a huge struggle initially, especially because we didn't find out our son had 3rd Degree Tongue Tie until he was 3 weeks old, and surgery to correct it was at 4 weeks. I just kept feeding him, and pumping when I needed a nipple break, despite the constant "maybe we should just do formula" from my slightly all-things-baby-uneducated hubby. I would say it was about 6 weeks before I really felt comfy being an EBF mom, but now, 8 months later, I feel like a pro and it comes so naturally to me. And in that 8 months, DH has learned how important Mumma's Milk Jugs are to our little guy, and that they aren't just there for food, they make the perfect nightime pillow :)

[Tricia]

You know, if someone read something I wrote - especially if it was about an experience that was painful for me - and then created a poll expressly for the purpose of gathering information to write a post about how wrong and lazy I was, I'd be pretty pissed off.

[phdinparenting]

@ Tricia - You obviously completely missed the point. It has nothing to do with her being lazy. Read the second paragraph. This has to do with explaining to her and others that it is completely inappropriate and dangerous to tell mothers to give up on breastfeeding at 2 weeks if it isn't going well, especially if they do want to continue.

[Tricia]

OK, I apologize for the lazy part. You're right, you didn't say that. However, I stand by what I said - I'd feel kind of violated if I were her and someone took issue with what I said to the point of actually creating a poll and a blog entry of their own about it, with a link back to my words.

Also, honestly, do you think someone who really wants to continue breastfeeding is going to stop at two weeks just because some random internet person said to? I read that more as "If you're having difficult to the point that you're driving yourself absolutely crazy, you're miserable, your baby is miserable, etc. - then it's not the absolute end of the world if you stop." Listen, I breastfeed my daughter. I love it, and at 8 months I have no plans to stop anytime soon. But I've been where she was - with my first daughter - and I know how it feels. I'd have been incredibly hurt by reading something like this when I'd put myself out there. If you feel that strongly about it, I think it would have been better not to include the link.

[Nicole]

The best piece of advice I received when I was pregnant with my first was that the first SIX WEEKS was the hardest. That helped me tremendously at FOUR weeks when we were still struggling b/c of nipple damage. Kelly Mom was my savior for that and I went on to BF both sons for the first year of their lives. TWO WEEKS is not nearly enough to have a goal for most women. I don't even consider my story one of the most challenging and yet, it still took us a good 4-6 weeks. I didn't have thrush, etc. or anything. It just hurt and my nipples had some damage.

That saddens me to think that some women do give up after just 2 weeks because of lack of support. :( I know it's not for everyone, but if you want to do it, I wish everyone had the support they needed. When I was preganant, I didn't really know what BF would be like...having "someone" latch on to your breast to eat, but it was by far one of my biggest accomplishments and bonding experiences with my two boys and I *LOVE* that I was able to do it.

[Think. Act. Breastfeed. | Brea]

[...] Then Green and Clean Mom shared a reader’s story called Breastfeeding or Bottlefeeding: A Personal Story which told of her decision to bottle feed after a horrendous struggle with breastfeeding. Then due to a statement she made that if breastfeeding is not working for new moms after two weeks they should just give up and switch to formula, PhD in Parenting was compelled to create a poll questioning moms about whether or not they had breastfeeding problems within the first two weeks of birth and if so, whether they quit breastfeeding or kept trying. Then she posted the results and her interpretation of her findings in When to give up on breastfeeding. [...]

[Candace]

I think every mother should do what she believes to be best for her family.

What I always tell new moms is that it does get better! If breastfeeding were as consuming and hard as it is during the first month for the entire year or more...then we never would have survived as a species.

So I always tell new moms that it will get better and that you can always stop later but you can't really start up again if you stop...so, if you want to breastfeed, give you and your baby some time. And then I let them know that I am there for them, and totally believe in their ability to make whatever is the right decision for their family.

[phdinparenting]

@ Candace - Thank you for your comment. I just wanted to add that you CAN start up again if you stop. It is called http://www.kellymom.com/bf/supply/relactation.html" rel="nofollow">relactating. I know a number of moms that have done it successfully.

[Lisa]

As a mother who had no choice but to pump, what do you think about that? My daughter refused to latch ever -- and ended up jaundiced instead. My choice was to admit her into the hospital or give her a bottle. I exclusively pumped for 4 months with her. Any help I could have gotten I was told had a price tag attached to it which we could not afford at that time. I quit at 4 months because I hated pumped and I started resenting her.

I thought with my son things would be better. No, instead nobody bothered to tell me he wasn't latching because he's tongue tied. I read that on the internet months later. He also got jaundiced because I was trying so desperately to breastfeed.

So with my experiences, I would tell a woman that if its not working, you have to do what's best for your kids.

[phdinparenting]

@ Lisa: My son was also tongue tied and I exclusively pumped for almost 3 months. I wrote about it in http://www.phdinparenting.com/2008/12/29/our-breastfeeding-story/" rel="nofollow">my breastfeeding story. I chose to keep going. But I also completely agree with your statement that a woman needs to do what is best for her kids. If breastfeeding is keeping her from being a good mother and making her resentful, she should stop if she wants to. I just don't think it is anyone else's place to tell a mother when to quit. They should support her in whatever choice she wants to make.

[Tracy]

Yep I agree that the idea of relactation should be discussed more.
I know of many women, traumatic birth, exhausted, ill, no help, bad advice, overwhelmed, various latching issues that can improve with maturity etc. Who very relunctantly gave up who had no idea they could try again later. Perhaps when they feel stronger and healthier to go seek the help they need. Sadly in this day and age it's not just there on hand, you have to go find it!

[Candace]

I know of adoptive moms who have even lactated (with no recent births)! So, I should have guessed that "relactating" was possible...but I do think if a woman is having a hard time breastfeeding and then gives it up, it is less likely this will be a promising avenue for her. Still, even if it is just a fit for a few women, it is good to have the info out there!

[Sommer @greenmom]

Annie,

I have to disagree with this comment:

"This is a great post! I can see why colleen’s comments made you so upset and I am so impressed about the way you collected data and wrote a great post about it!

AND frankly your reaction to the personal story(that was removed from the negative comments and feelings of personal attacks - so sad) and the only ones impressed were those that ended up being successful. The poll was to support your opinion and it wasn't just "gathering" data. Who reads your site? What is your demographic - those that don't succeed at breastfeeding or those that have? The information is biased and it singled out the person behind the personal story and all the other moms who don't breastfeed, stopped and don't read your site. Putting a poll on a variety of mom sites would be much more diverse and fair.

Here is my real issue: You believe it isn't easy, it's good for the baby and women who decide to breastfeed should be supported? Correct? What about those that decide to NOT breastfeed or decide to quit because "their" emotional, mental or physical boundaries are different than yours? What you have done is drawn a line in the sand and puts you on one side and someone else on the other.

Shouldn't the most important thing be a healthy mom and baby? Shouldn't moms feel less judged and more supported? I don't sense support or COMPASSION. The smell is clearly a mob of women that are pro breastfeeding and it is there way or the highway but NO that is not the case. We can't all see the same way or have the same capabilities or handle the same stresses.

I admire you passion, your information, your website but what I stress to all women of all walks of life on all topics is that we should inspire, support and motivate but let's not judge or condemn one another. Let's show more compassion because motherhood is tough and it isn't the same for all of us.

[phdinparenting]

@ Sommer

Thank you for your comment.

You are right that most of the moms that read my site were successful at breastfeeding. I did make a few attempts to reach out to formula feeding moms via twitter and facebook to get them to reply to the poll too, but wasn't that successful. However, that doesn't change the fact that of the moms that WERE successful at breastfeeding, almost half of them were still struggling at 2 weeks. That is the key point. If everyone gave up at 2 weeks, like the guest poster on your site suggested, then breastfeeding rates would plummet. And yes, I recognize it is the moms that were successful at breastfeeding that are congratulating me because they realize how horrible it was when people undermined their wish to continue breastfeeding.

To answer your questions.

1) Yes, I think that women that want to breastfeed should be supported and should not be undermined.

2) I also support those that decide NOT to breastfeed or decide to quit because their emotional, mental or physical boundaries are different than mine.

3) What I DO NOT support is their belief that they need to tell other people that they should make the same decision.

I agree. The most important thing is a healthy mom and baby. That has been proven by research. If a mom cannot be happy while breastfeeding, then she shouldn't breastfeed. However, if a mom is struggling at 2 weeks and wants to continue, having everyone tell her to quit is NOT the answer to making her happy.

I took great pain to explain my compassion for the situation of your guest poster in my second paragraph. This really was not an attack on HER choice about how to feed HER baby. It was an attempt to show her (and others that may inadvertently undermine breastfeeding women) the inappropriateness of assuming her decision is what is right for everyone else that goes through a similar struggle.

I went to great pains to explain this several times and I'm sorry she keeps seeing it as a personal attack. That is not what it is. It is a difference of opinion on a topic that is very important to me. I'm glad the blogosphere gives us the opportunity to have these types of engaging conversations and I think it is too bad when people take things personally. It saddens me, but it isn't going to make me stop discussing what I think are important and controversial topics.

Thanks for following up. I appreciate your comments.

[Meagan Francis]

I always tell new moms that they most likely won't get a feel for how easy breastfeeding CAN be until they've passed the 6-week mark--that it can easily take that long to establish supply, set a routine, and feel like you have any idea what you're doing. So IMO, two weeks is way too early of a give-up point if you really want to breastfeed. At two weeks postpartum, I still feel barely human--it's not a time I'd choose to make a major decision like discontinuing breastfeeding.

[Ruth Moss]

I posted this on the site:

I was one of those women for whom it took eight weeks for breastfeeding to get going.

I too was upset and distressed to read “if it’s not working by two weeks, change to formula”. Because that’s what everyone - EVERYONE said to me when I was struggling.

Stop.

Just stop.

One person even drove me to the chemists to buy formula while my face was red with tears.

That attitude drove me to the point of severe Postnatal Depression from which I’m still recovering, nearly two years later.

If it’s your personal opinion that *you* wished you’d stopped after two weeks then so be it. Fair enough. But please, please, please don’t tell other women to give up after two weeks if it isn’t working out.

Because it is women like you, who said that to me, that made my life into such a hell for the first two months of my baby’s life. I was told I was being stubborn, above myself, that I needed to stop, that I should just give formula, after all it isn’t poison!

And I was unutterably grateful when I finally, at eight weeks, found a midwife who actually said, “something’s wrong here, let’s get it sorted out so you can enjoy exclusive breastfeeding”.

She didn’t say give up.

She didn’t say I was being stubborn.

She helped me. And now at two years, we’re still breastfeeding.

I think the reason your post has upset Annie to the point of actually making a poll is because of this very reason. If I had read your article when I was struggling, and given up when it wasn’t working out at two weeks, it would have dragged me even further down into the mire.

I’m happy it worked for you. But what you’re doing is telling other Mums what to do. So maybe YOU should be the one who listens to your own advice: “Moms need to support one another.”

[Karen Buterfield]

I can see why that comment upset you and prompted you to write the article. As a breastfeeding supporter I always tell mums that there is a 6 week mark. At this point you have a better idea of what you are doing, so does baby, your body produces enough milk to meet demand and things just start to get easier from there.

I feel so sad when I hear things like that as I hear it all too often. Interfering but well meaning friends & family usually do more harm than good and its a shame as I have recently heard that 9 out of 10 mums that stop breastfeeding in the early days wish that they hadn't.

[Francesca]

Not to add fuel to the fire but i'd just like to add something. Breastfeeding is THAT important to me. I feel i need to say this, even though i have already commented.
When you stat a new job, you have a 3 month triel period (at least in the UK you do). That is because employers view it as taking THAT long before they know whether you are working out, and it propbably takes you that long (if not even longer) to know the same and to settle in.
With a new boyfriend / girlfriend the benchmark seems to be 3 months as well. THAT is when most relationships that don't progress to Long Term end up being broken off. Somehow it sort of takes 3 months for it to either be going well and then go bad or for it to be not that good but lets keep going and see how it goes.
What else? Notice periods in most jobs - 3 months! at lest over here in the UK and for every firm i have worked for.
so what is my point?
with everything in life you have to give things time. Not everything is easy. Parenting certainly isn't. It's about being selfless. it really is. I'm not now advocating that you have to kep trying to make breastfeeding work for 3 months. My point with teh whoe 3 months thing is that with other "things" you tend to give 12 weeks. NOT 2 weeks. 2 weeks is NOTHING. For all the good that breastfeeding does to allow yourself and your baby only 2 weeks is crazy. Not only does it put a mum under immense pressure but it also doesn't give anyone any time. In two weeks if you manage to have the time to see a lactation consultant you are a supermum because i know that at 2 weeks i had barely got out of my pajamas.
What i am trying to say is that we need to re-establish just how IMPORTANT breastfeeding is and make it clear that it may well be difficult but it is soooo important to give it time, ask for help and support, and to persevere for more than 2 weeks. I m not going to say how long any woman should persevere for. That is her decision and if she chooses 2 weeks, so be it. But she shouldn't advise any other mums that 2 weeks is a good enough point to stop. That is wrong.
In any case, i a world where we give so many other things MORE than 2 wees, be they jobs, relationships, new schools, a new course, moving to a new city/country, it is sad that some mums do not give something as important as breastfeeding more than 2 weeks

[FamilyNature]

I have been reading this p0st and comments with interest; it took me 8 weeks to establish breastfeeding with my first child.

I find it upsetting that when people are passionate and vocal about breastfeeding they are so often labeled as "unsupportive". There have been many other negative words used here to describe PhD's post and quite frankly, I don't undstand. I don't understand why people are upset.

When I go back and re-read the blog post I read things like:

"Her story is sad"

"I don’t blame her."

"I don’t judge her (or anyone) for choosing formula if they feel that they cannot breastfeed for whatever reason."

"...lactation professionals need to choose their words carefully so that they don’t place blame on the mother or make her feel inadequate."

"Tell her that it is her choice whether to continue or not and that you fully support her no matter what her decision is and that she is a great mother no matter what decision she makes"

"let her heart guide her about when or if to give up"

"I sympathize with the woman that wrote the original post and I know her heart is in the right place"

Not once does PhD criticize the mother, or any mother. There is no name calling. There is no judgement. It seems that PhD went to great lengths to write in an unoffensive way. So I have to wonder...what exactly are people upset about? I mean specifically; what words or sentences do people find offensive? 'Cause I just don't get it.

[Kelly]

I have a foot on both sides of the line here.

I can understand Colleen's hurt. I gave up at the one week mark and whenever I read about some of the extreme struggles that some women deal with for weeks more, sometimes months more, it stings. Part of me thinks they are fools or martyrs to put themselves through such agony. But then I think of how I grieve for the loss of the breastfeeding relationship I might have had with my first son had I stuck it out for a few more weeks. I feel guilt for how easily I gave up and I am angry at those around me for not encouraging me to continue.

And when I look at my beautiful, healthy son I have no doubt he was not harmed at all from formula. He has thrived. Most children will. I am NOT DIMINISHING the important public health benefits of breastfeeding. Rather I am emphasizing that the grief I feel over my failure is over the loss of the breastfeeding relationship and experience. I feel that I was less of a mother; hell, less of a mammal. But when I read about moms who struggled so mightily for weeks and months to "give their child the best start" I can't help but feel insulted as my son has done just fine thank you oh so much. I did give him the best start. I loved him, cuddled him, held him nurtured him . . . What I'd like to see is some acknowledgment that for the women who struggled for so long that they did so because succeeding at breastfeeding was important to them, to their identify as mothers, to their self-esteem and sense of accomplishment. It wasn't just so that their babies would receive breastmilk. Because when that is how their struggles are presented, what moms like myself and Colleen take away is that these women sacrificed more for their babies. Perhaps that isn't the intent.

Now I find myself with the foot planted firmly on the other side. I am due in five weeks with my second son. Based on the nature of my previous difficulties, I fully expect to encounter problems again. Lactogenesis II will be delayed, it will take significant help -- pumping, herbs, perhaps medication, to build even a partial milk supply. I have almost no chance of an exclusive breastfeeding relationship. But I fully appreciate how important it is to me to give it my all so that I can have some sort of breastfeeding relationship with my new baby. I need to accomplish that. So I have made this need known to my "team." I've communicated that even though it may pain them to see me struggle and suffer, encouraging me to quit BF is not "support."

Colleen -- I understand your pain. Your voice sounds so much like my own four+ years ago. I hope you have someone IRL with which to discuss your anguish. Love your baby and yourself.

Annie, et al. You mean well and you are doing good work. I hope to soon count myself as someone who continues breastfeeding because of the good information and support found at sites like this and others.